Recovery in Behaviorally Vulnerable Populations - Center for Healthcare Organization & Implementation Research
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Recovery in Behaviorally Vulnerable Populations

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Enhancing Recovery-Oriented Care for Behaviorally Vulnerable Populations

A major CHOIR goal is to facilitate the transformation of VA to a recovery-oriented healthcare system through research to improve recovery-oriented outcomes for behaviorally vulnerable Veterans, specifically those with mental health conditions, substance use disorders, traumatic brain injury, or who are homeless or at risk for suicide. This goal derives from our longstanding partnerships with the Office of Mental Health and Suicide Prevention (OMHSP), the National Center on Homelessness Among Veterans (NCHAV), and the Veterans Justice Program (VJP).

Recovery road map activities will include a workstream of research which aligns with the VA Secretary’s priority of Suicide Prevention, and which draws on our traditional strengths in recovery: Recovery-Oriented Approaches to Suicide Prevention. The Committee acknowledged that most suicide prevention efforts scientifically studied to date have focused on identifying demographic and clinical risk factors that often involve restrictions of personal freedom and decision-making. However, the Committee is interested in learning about interventions that are recovery-oriented, emphasizing personal choice and function in the least restrictive level of care despite high potential for self-harm.

In support of this, we have developed the following 5-year plan:

1. Year 1: We will conduct a scoping review of interventions for suicide risk-reduction, with a particular focus on assessing the recovery-orientation of the intervention based on our Committee’s previous systematic review by Ellison et al (2018). The review publication will be a milestone and include both peer-reviewed and gray literature—the latter in order to identify the various programs that are used in the community but have not yet been subjected to scientific scrutiny.

2. Year 2: Development and submission of a proposal to do an environmental scan of VA suicide prevention efforts, encompassing both VA Central Office- and facility-initiated programs.

3. Years 3-5: We will build on the above efforts to develop and test a recovery-oriented, Veteran-focused intervention for suicide risk reduction. This intervention will likely involve pilot and IIR grants to address both effectiveness and implementation aspects. In this workstream, we will closely collaborate with our organizational partners in OMHSP, other VA health services researchers, our Veteran advisors, and CHOIR investigators in the Healthcare Communications Scientific Focus Area’s Whole Health Initiative.     

Thus, the Recovery Focus represents a broad and synergistic portfolio of investigators, topics, and methodologies to advance the transformation of VA to a recovery-oriented healthcare system.  These efforts are organized by a Coordinating Committee in consultation with an Advisory Committee comprised of stakeholders ranging from VA Central Office operational leaders to frontline clinical staff and consumers.  In addition to review of individual scientific studies and program evaluation projects, the Recovery Focus creates additional synergy by sharing information among investigators and others interested in recovery via:

  • Listserv for VA and non-VA investigators, trainees, and staff interested in recovery.
  • Internal CHOIR SharePoint to facilitate information sharing.
  • Regular investigator meetings open to all CHOIR and affiliated investigators, fellows, and staff.

For questions regarding CHOIR Recovery Focus work, contact Keith McInnes, ScD or Terri K. Pogoda, PhD, the Recovery Focal Area Co-Chairs.

Recovery Focal Group Coordinating Committee:
Keith McInnes, PhD and Terri Pogoda, PhD, Co-Chairs
Tom Byrne, PhD
Martin Charns, DBA
Mary Alexis Greenan, MPH, Recovery Coordinator 
Justeen Hyde, PhD
Christopher Miller, PhD
Barbara Niles, PhD